Real-time elastography in the diagnosis of prostate tumor

Abstract

KEYWORDSProstate cancer; Ultrasonography; Real-time elastography.Abstract Aim: To assess the diagnostic gain of transrectal real-time elastography (RTE) compared to transrectal B-mode ultrasonography (US) in the detection of tumors in patients suspected of having prostate cancer. Materials and methods: Eighty-four patients suspected of having prostate cancer on the basis of clinical and biochemical evaluation underwent transrectal US, RTE and transperineal prostate biopsy. Results: Biopsy was considered the gold standard. Analysis related to the total number of patients showed a B-mode US sensitivity of 56%, specificity 80%, positive predictive value (PPV) 70% and negative predictive value (NPV) 67%. Analysis related to the total number of biopsy cores showed sensitivity 33%, specificity 92%, PPV 69% and NPV 73%. In the patientrelated analysis, RTE sensitivity was 51%, specificity 75%, PPV 64% and NPV 64%, while the core-related analysis showed sensitivity 36%, specificity 93%, PPV 72% and NPV 74%. Comparison of B-mode US and RTE diagnostic accuracy in the detection of tumors located in the peripheral zone of the prostate gland showed a significant difference. Analysis related to the total number of biopsy cores harvested in the peripheral zone of the prostate gland showed a B-mode US sensitivity of 48%, specificity 81%, PPV 75% and NPV 58%, whereas RTE achieved the following values: sensitivity 66%, specificity 78%, PPV 77%, and NPV 67%. Conclusions: RTE is a valid addition to B-mode US, and RTE reached a higher accuracy than Bmode US in the evaluation of the peripheral zone of the prostate gland and in the selection of appropriate biopsy sites.Sommario Scopo: Verificare il guadagno diagnostico dell'elastosonografia transrettale realtime (RTE) rispetto alla ecografia transrettale B-mode nel rilievo del tumore prostatico in una popolazione di pazienti con sospetto di neoplasia. Materiali e metodi: Ottantaquattro pazienti con sospetto clinico-laboratoristico di tumore prostatico sono stati valutati mediante ecografia transrettale, elastosonografia e biopsia transperineale. Risultati: L'esame bioptico è stato considerato lo standard di riferimento. Nella valutazione per paziente, la sensibilità dell'ecografia B-mode è stata del 56%; la specificità dell'80%; il valore predittivo positivo (VPP) del 70%, il valore predittivo negativo (VPN) del 67%. Nella valutazione sul totale dei prelievi bioptici la sensibilità è stata del 33%, la specificità del 92%, il VPP del 69%, il VPN del 73%. La RTE ha ottenuto i seguenti risultati nella valutazione per paziente: sensibilità 51%, specificità 75%, VPP 64% e VPN 64%. Nella valutazione sul totale dei prelievi bioptici: sensibilità 36%, specificità 93%, VPP 72%, VPN 74%. Confrontando i valori di accuratezza dell'ecografia B-mode e della RTE per i tumori della zona periferica, è stata trovata una differenza significativa. Nella valutazione sul totale dei prelievi bioptici della zona periferica la sensibilità dell'ecografia B-mode è stata del 48%, la specificità dell'81%, il VPP d...

Comparison of meta-analyses among elastosonography (ES) and positron emission tomography/computed tomography (PET/CT) imaging techniques in the application of prostate cancer diagnosis

“…In the process of recognizing and selecting associated studies with 11C-choline PET/CT [5,[8][9][10], 18F-FCH PET/ CT [20,44,[49][50][51][52][53][54][55][56][57][58][59][60][61], 11C-acetate PET/CT [7,13,14,62,63], 18F-FDG PET/CT [64][65][66][67][68], TRTE [11,12,[69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88], and SWE [3,…”

Transrectal real-time elastography of the prostate: Normal patterns

“…Reports published in 2008e2009 indicate that an elastographic examination takes 7e10 min [15,16]; those in our study lasted 3e7 min (mean: 5 min). The fact that less time was required for our examinations reflects recent software advances that improve the sensitivity of elastography.…”

“…For the former, which is softer, linear/serpiginous signal morphologies were associated with pattern A (homogeneous representation of red and green) or pattern B (predominantly green with smaller areas of blue and red). For the transition zone, the morphology was more heterogeneous, essentially micronodular, with patterns A, B, and C (where the color blue was predominant) [15].…”

“…At the end of a conventional TRUS examination, with the patient lying on his left side, transrectal elastography is performed with the same transducers used for TRUS. Different types of transducers can be used for elastographic studies: convex, linear, or biplanar probes with frequencies ranging from 3.5 to 12 MHz [15,26]. In our study, we used convex end-fire transducers with frequency ranges of 4e8 MHz and 5e9 MHz.…”

Transrectal sonoelastography in the detection of prostate cancers: a meta‐analysis

“…The accuracy of transrectal sonoelastography (TRSE) in PCa detection has been discussed in various studies. In patients suspected of having PCa, TRSE targeted biopsy yields a sensitivity ranging from 51.1 to 91.7% and a specificity ranging from 62.2 to 86.8% [5,8,10–17], while in patients with proven PCa, the sensitivity and specificity of TRSE are ∼80% based on step‐section pathological analysis after radical prostatectomy [18,19].…”